Daytime Sleep: Comfort And Calm Amidst Chaos

Feeling sleepy during the day can be caused by a variety of factors, including sleep disorders, medications, medical or psychiatric illnesses, and environmental factors. Sleep disorders such as sleep apnea, restless leg syndrome, and insomnia can disrupt sleep quality and contribute to daytime sleepiness. Medical conditions like hypothyroidism, depression, and anxiety can also play a role. Additionally, medications, alcohol consumption, and environmental factors such as noise or light can impact sleep patterns. Addressing these underlying causes and improving sleep hygiene can help mitigate excessive daytime sleepiness.

Sleep disorders

Primary Hypersomnia Disorders

• Narcolepsy Type 1: Characterised by sudden muscle weakness triggered by emotions, this type of narcolepsy is caused by low levels of the brain chemical hypocretin.
• Narcolepsy Type 2: This type does not include cataplexy and has less severe symptoms and normal levels of hypocretin.
• Kleine-Levin Syndrome: Recurring episodes of extreme hypersomnia, usually accompanied by mental, behavioural, and psychiatric disturbances.
• Idiopathic Hypersomnia: Characterised by excessive nighttime sleeping and daytime napping, this disorder occurs for unknown reasons.

Secondary Hypersomnia Disorders

• Hypersomnia due to a medical condition: Diseases and conditions that can cause hypersomnia include epilepsy, hypothyroidism, encephalitis, multiple sclerosis, Parkinson’s disease, obesity, obstructive sleep apnea, delayed sleep phase syndrome, multiple systems atrophy, myotonic dystrophy, and other genetic disorders.
• Hypersomnia due to medications or alcohol: Sedating medications, anti-hypertensive drugs, anti-epileptic drugs, anti-parkinsonian agents, skeletal muscle relaxants, antipsychotics, opiates, cannabis, and alcohol can all cause hypersomnia.
• Hypersomnia due to insufficient sleep: This can be caused by long working hours, family demands, study, or social life.
• Circadian Rhythm Sleep Disorders: These occur when the body's internal clock, which controls the sleep-wake cycle, is not functioning properly.

Other Factors That May Cause Excessive Daytime Sleepiness

• Environmental factors: These include a snoring partner, a baby that wakes up at night, noisy neighbours, uncomfortable temperatures, etc.
• Shift work: It is very difficult to get good sleep while working night shifts, and this can cause a misalignment with the body's internal clock.
• Mental states: Anxiety can keep a person awake at night, and depression can sap energy.
• Medications: Alcohol, caffeinated drinks, tranquillisers, sleeping pills, and antihistamines can all disrupt sleeping patterns.
• Medical conditions: Hypothyroidism, oesophageal reflux, nocturnal asthma, and chronic painful conditions can disrupt sleep.
• Changes to time zone: Jet lag can affect the internal biological clock, which regulates sleep.
• Sleep apnea: A person's breathing stops or is reduced during sleep, causing them to rouse slightly and gasp for air before falling back asleep.
• Insomnia: This is very common but does not necessarily cause hypersomnia.
• Restless leg syndrome: Sensations of cramps or irritation in the legs can make it difficult to fall and stay asleep.
• Sleepwalking: This is a common abnormal behaviour during sleep that tends to affect children more than adults.

If you are experiencing excessive daytime sleepiness, it is important to consult a healthcare professional to determine the underlying cause and explore possible treatments.

Medication and medical conditions

There are several medications that can cause excessive daytime sleepiness. These include:

• Sedatives
• Antidepressants
• Pain medications
• Over-the-counter antihistamines
• Sleeping pills
• Antipsychotics
• Some antidepressants
• Stimulants
• Anticonvulsants
• Lithium
• Antinausea medications
• Opioids

Additionally, withdrawal from some drugs may also cause drowsiness. It is important to discuss medication and potential side effects with a doctor. They can offer guidance on timing and dosage and make adjustments as needed. Do not make any changes to your medication without consulting a healthcare professional.

Excessive daytime sleepiness can also be caused by other medical conditions, including:

• Sleep disorders such as insomnia, sleep apnea, and restless leg syndrome
• Mental health disorders such as depression, bipolar disorder, post-traumatic stress disorder, and anxiety
• Neurological conditions such as narcolepsy
• Neurodegenerative diseases such as dementia and Parkinson's disease
• Neurodevelopmental disorders such as ADHD and autism
• Metabolic problems such as diabetes and hypothyroidism
• Medical conditions like anemia, abnormal blood sodium levels, and electrolyte imbalances

Lifestyle habits

If you feel more comfortable sleeping during the day, you may be experiencing hypersomnia, or excessive daytime sleepiness (EDS). This is a condition where you feel extremely sleepy during the day, despite getting a full night's sleep. Here are some lifestyle habits that may be contributing to this:

• Irregular sleep schedule: Keeping irregular hours, such as working night shifts or staying up late on the weekends, can disrupt your body's natural sleep-wake cycle, known as the circadian rhythm. This can result in feeling sleepy during the day.
• Environmental factors: Factors such as a snoring partner, a noisy baby, loud neighbours, an uncomfortable mattress, or extreme temperatures can cause broken sleep and contribute to daytime sleepiness.
• Mental health: Anxiety and depression can impact your sleep. Anxiety can keep you awake at night, making you prone to sleepiness during the day. Depression can sap your energy and is associated with changes in sleep patterns, such as sleeping more or less than usual.
• Substance use: Alcohol, caffeinated drinks, and certain medications (e.g., tranquillizers, sleeping pills, antihistamines) can disrupt your sleep patterns and contribute to daytime sleepiness.
• Medical conditions: Certain medical conditions, such as hypothyroidism, oesophageal reflux, nocturnal asthma, or chronic pain, can interfere with your sleep, leading to hypersomnia.
• Time zone changes: Jet lag or shift work can affect your internal biological clock, known as the circadian rhythm, which regulates sleep. This can result in feeling sleepy at unusual times.
• Poor sleep hygiene: This includes habits such as using electronic devices before bed, consuming large meals, caffeine, or alcohol before bed, and not getting enough physical activity during the day. Poor sleep hygiene can lead to restless sleep and daytime sleepiness.

If you are experiencing hypersomnia, it is important to consult a healthcare professional to identify any underlying causes and determine the best treatment options for you.

Mental health

Feeling more comfortable sleeping during the day can be a sign of various mental health issues. Sleep and mental health are closely linked, and living with a mental health problem can affect how well you sleep.

Depression

Depression is one of the most common mental health issues associated with changes in sleep patterns. A noticeable change in your sleep routine can be a symptom of depression. You may sleep much more or much less than usual. Other symptoms of depression include low motivation, irritability, changes in appetite, feelings of hopelessness, and a loss of interest in your favourite activities. Depression can also cause insomnia.

Anxiety

Anxiety can cause racing or repetitive thoughts and worries that keep you awake at night. It can also lead to panic attacks while you're trying to sleep. Additionally, anxiety can make you feel tired during the day, as it can keep you awake at night, making you prone to sleepiness during the day.

Trauma

Traumatic experiences can cause flashbacks, nightmares, or night terrors that disturb your sleep. You might feel unsafe or uncomfortable in bed or in the dark, impacting your sleep quality.

Mania

Mania often results in feelings of high energy and elation, which can interfere with your sleep. Racing thoughts can keep you awake and cause insomnia.

Psychiatric medication

Medications used to treat mental health conditions can have side effects that impact your sleep. These may include insomnia, disturbed sleep, nightmares, and oversleeping. Additionally, stopping psychiatric medication can also lead to sleep problems.

Seasonal Affective Disorder (SAD)

SAD, a type of depression associated with seasonal changes, can also affect your sleep patterns. It may lead to sleeping more, including staying in bed longer or sleeping more frequently.

Other factors

In addition to specific mental health conditions, other factors can contribute to feeling more comfortable sleeping during the day:

• Stress: Worries about issues like money, housing, or work can disrupt your sleep.
• Sleep environment: Sleeping in an uncomfortable place or being easily disturbed can impact your sleep quality.
• Shift work: Working irregular hours, especially night shifts, can disrupt your sleep and affect your body's internal clock or circadian rhythm.
• Medication: Certain medications, including alcohol, caffeinated drinks, tranquilizers, sleeping pills, and antihistamines, can disrupt your sleep patterns.
• Medical conditions: Various medical issues, such as hypothyroidism, oesophageal reflux, nocturnal asthma, or chronic pain, can interfere with sleep.
• Time zone changes: Jet lag can affect your internal biological clock, leading to sleep disturbances.
• Sleep disorders: Conditions like sleep apnea, restless leg syndrome, sleepwalking, and insomnia can cause sleep disruption or fragmented sleep.

Environmental factors

• Noise: Noisy surroundings, such as a snoring partner, a baby that wakes up frequently, or loud neighbours, can disrupt sleep.
• Temperature: Extremes of heat and cold can affect sleep quality. Maintaining a comfortable temperature in the bedroom is essential for a good night's rest.
• Mattress: Sleeping on an uncomfortable mattress can cause broken sleep. Ensuring your mattress is suitable for your body and sleep preferences can improve sleep quality.
• Light: Excess light in the bedroom, such as from electronic devices or a bright room, can interfere with sleep. Reducing light exposure and creating a dark environment can promote better sleep.
• Work schedule: Working night shifts or having irregular work hours can disrupt the body's internal clock (circadian rhythm), making it challenging to get quality sleep.
• Time zone changes: Jet lag or frequent travel across multiple time zones can affect the body's internal biological clock, leading to sleep disturbances.
• Social life: A busy social life or family demands, such as caring for a new baby, can result in inadequate sleep.

Frequently asked questions